Nocturnal blood pressure fall as predictor of diabetic nephropathy in hypertensive patients with type 2 diabetes
Autor(a) principal: | |
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Data de Publicação: | 2010 |
Outros Autores: | , , , , |
Tipo de documento: | Artigo |
Idioma: | eng |
Título da fonte: | Repositório Institucional da UNIFESP |
Texto Completo: | http://repositorio.unifesp.br/handle/11600/32821 http://dx.doi.org/10.1186/1475-2840-9-36 |
Resumo: | Background: Hypertensive patients with reduced blood pressure fall (BPF) at night are at higher risk of cardiovascular events (CVE).Methods: We evaluated in hypertensive diabetic patients, if a reduced nocturnal BPF can precedes the development of diabetic nephropathy (DN). We followed 70 patients with normal urinary albumin excretion (UAE) for two years. We performed 24-hours ambulatory BP monitoring in baseline and at the end of the study.Results: Fourteen (20%) patients (GI) developed DN (N = 11) and/or CVE (n = 4). Compared to the remaining 56 patients (GII) in baseline, GI had similar diurnal systolic (SBP) and diastolic BP (DBP), but higher nocturnal SBP (138 +/- 15 vs 129 +/- 16 mmHg; p < 0.05) and DBP (83 +/- 12 vs 75 +/- 11 mmHg; p < 0,05). Basal nocturnal SBP correlated with occurrence of DN and CVE (R = 0.26; P < 0.05) and with UAE at the end of the study (r = 0.3; p < 0.05). Basal BPF (%) correlated with final UAE (r = -0.31; p < 0.05). in patients who developed DN, reductions occurred in nocturnal systolic BPF (12 +/- 5 vs 3 +/- 6%, p < 0,01) and diastolic BPF (15 +/- 8 vs 4 +/- 10%, p < 0,01) while no changes were observed in diurnal SBP (153 +/- 17 vs 156 +/- 16 mmHg, NS) and DBP (91 +/- 9 vs 90 +/- 7 mmHg, NS). Patients with final UAE < 20 mu g/min, had no changes in nocturnal and diurnal BP.Conclusions: Our results suggests that elevations in nocturnal BP precedes DN and increases the risk to develop CVE in hypertensive patients with T2DM. |
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Felicio, Joao S.Souza, Ana Carolina C. B. deKohlmann, Narcia [UNIFESP]Kohlmann, Osvaldo [UNIFESP]Ribeiro, Arthur Beltrame [UNIFESP]Zanella, Maria Teresa [UNIFESP]Universidade Federal do Pará (UFPA)Universidade Federal de São Paulo (UNIFESP)2016-01-24T14:05:20Z2016-01-24T14:05:20Z2010-08-13Cardiovascular Diabetology. London: Biomed Central Ltd, v. 9, 6 p., 2010.1475-2840http://repositorio.unifesp.br/handle/11600/32821http://dx.doi.org/10.1186/1475-2840-9-36WOS000282267300001.pdf10.1186/1475-2840-9-36WOS:000282267300001Background: Hypertensive patients with reduced blood pressure fall (BPF) at night are at higher risk of cardiovascular events (CVE).Methods: We evaluated in hypertensive diabetic patients, if a reduced nocturnal BPF can precedes the development of diabetic nephropathy (DN). We followed 70 patients with normal urinary albumin excretion (UAE) for two years. We performed 24-hours ambulatory BP monitoring in baseline and at the end of the study.Results: Fourteen (20%) patients (GI) developed DN (N = 11) and/or CVE (n = 4). Compared to the remaining 56 patients (GII) in baseline, GI had similar diurnal systolic (SBP) and diastolic BP (DBP), but higher nocturnal SBP (138 +/- 15 vs 129 +/- 16 mmHg; p < 0.05) and DBP (83 +/- 12 vs 75 +/- 11 mmHg; p < 0,05). Basal nocturnal SBP correlated with occurrence of DN and CVE (R = 0.26; P < 0.05) and with UAE at the end of the study (r = 0.3; p < 0.05). Basal BPF (%) correlated with final UAE (r = -0.31; p < 0.05). in patients who developed DN, reductions occurred in nocturnal systolic BPF (12 +/- 5 vs 3 +/- 6%, p < 0,01) and diastolic BPF (15 +/- 8 vs 4 +/- 10%, p < 0,01) while no changes were observed in diurnal SBP (153 +/- 17 vs 156 +/- 16 mmHg, NS) and DBP (91 +/- 9 vs 90 +/- 7 mmHg, NS). Patients with final UAE < 20 mu g/min, had no changes in nocturnal and diurnal BP.Conclusions: Our results suggests that elevations in nocturnal BP precedes DN and increases the risk to develop CVE in hypertensive patients with T2DM.Fed Univ Para, UFPA, Div Endocrinol, BR-66059 Belem, Para, BrazilUniversidade Federal de São Paulo, UNIFESP, Endocrinol & Nephrol Div, São Paulo, BrazilUniversidade Federal de São Paulo, UNIFESP, Endocrinol & Nephrol Div, São Paulo, BrazilWeb of Science6engBiomed Central LtdCardiovascular DiabetologyNocturnal blood pressure fall as predictor of diabetic nephropathy in hypertensive patients with type 2 diabetesinfo:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/articleinfo:eu-repo/semantics/openAccessreponame:Repositório Institucional da UNIFESPinstname:Universidade Federal de São Paulo (UNIFESP)instacron:UNIFESPORIGINALWOS000282267300001.pdfapplication/pdf350931${dspace.ui.url}/bitstream/11600/32821/1/WOS000282267300001.pdf08ff48db109cbd56c4290630fca61906MD51open accessTEXTWOS000282267300001.pdf.txtWOS000282267300001.pdf.txtExtracted texttext/plain27239${dspace.ui.url}/bitstream/11600/32821/2/WOS000282267300001.pdf.txt6f1b9253f2b8ab5a1ac02080b715974eMD52open access11600/328212021-10-04 21:22:56.292open accessoai:repositorio.unifesp.br:11600/32821Repositório InstitucionalPUBhttp://www.repositorio.unifesp.br/oai/requestopendoar:34652021-10-05T00:22:56Repositório Institucional da UNIFESP - Universidade Federal de São Paulo (UNIFESP)false |
dc.title.en.fl_str_mv |
Nocturnal blood pressure fall as predictor of diabetic nephropathy in hypertensive patients with type 2 diabetes |
title |
Nocturnal blood pressure fall as predictor of diabetic nephropathy in hypertensive patients with type 2 diabetes |
spellingShingle |
Nocturnal blood pressure fall as predictor of diabetic nephropathy in hypertensive patients with type 2 diabetes Felicio, Joao S. |
title_short |
Nocturnal blood pressure fall as predictor of diabetic nephropathy in hypertensive patients with type 2 diabetes |
title_full |
Nocturnal blood pressure fall as predictor of diabetic nephropathy in hypertensive patients with type 2 diabetes |
title_fullStr |
Nocturnal blood pressure fall as predictor of diabetic nephropathy in hypertensive patients with type 2 diabetes |
title_full_unstemmed |
Nocturnal blood pressure fall as predictor of diabetic nephropathy in hypertensive patients with type 2 diabetes |
title_sort |
Nocturnal blood pressure fall as predictor of diabetic nephropathy in hypertensive patients with type 2 diabetes |
author |
Felicio, Joao S. |
author_facet |
Felicio, Joao S. Souza, Ana Carolina C. B. de Kohlmann, Narcia [UNIFESP] Kohlmann, Osvaldo [UNIFESP] Ribeiro, Arthur Beltrame [UNIFESP] Zanella, Maria Teresa [UNIFESP] |
author_role |
author |
author2 |
Souza, Ana Carolina C. B. de Kohlmann, Narcia [UNIFESP] Kohlmann, Osvaldo [UNIFESP] Ribeiro, Arthur Beltrame [UNIFESP] Zanella, Maria Teresa [UNIFESP] |
author2_role |
author author author author author |
dc.contributor.institution.none.fl_str_mv |
Universidade Federal do Pará (UFPA) Universidade Federal de São Paulo (UNIFESP) |
dc.contributor.author.fl_str_mv |
Felicio, Joao S. Souza, Ana Carolina C. B. de Kohlmann, Narcia [UNIFESP] Kohlmann, Osvaldo [UNIFESP] Ribeiro, Arthur Beltrame [UNIFESP] Zanella, Maria Teresa [UNIFESP] |
description |
Background: Hypertensive patients with reduced blood pressure fall (BPF) at night are at higher risk of cardiovascular events (CVE).Methods: We evaluated in hypertensive diabetic patients, if a reduced nocturnal BPF can precedes the development of diabetic nephropathy (DN). We followed 70 patients with normal urinary albumin excretion (UAE) for two years. We performed 24-hours ambulatory BP monitoring in baseline and at the end of the study.Results: Fourteen (20%) patients (GI) developed DN (N = 11) and/or CVE (n = 4). Compared to the remaining 56 patients (GII) in baseline, GI had similar diurnal systolic (SBP) and diastolic BP (DBP), but higher nocturnal SBP (138 +/- 15 vs 129 +/- 16 mmHg; p < 0.05) and DBP (83 +/- 12 vs 75 +/- 11 mmHg; p < 0,05). Basal nocturnal SBP correlated with occurrence of DN and CVE (R = 0.26; P < 0.05) and with UAE at the end of the study (r = 0.3; p < 0.05). Basal BPF (%) correlated with final UAE (r = -0.31; p < 0.05). in patients who developed DN, reductions occurred in nocturnal systolic BPF (12 +/- 5 vs 3 +/- 6%, p < 0,01) and diastolic BPF (15 +/- 8 vs 4 +/- 10%, p < 0,01) while no changes were observed in diurnal SBP (153 +/- 17 vs 156 +/- 16 mmHg, NS) and DBP (91 +/- 9 vs 90 +/- 7 mmHg, NS). Patients with final UAE < 20 mu g/min, had no changes in nocturnal and diurnal BP.Conclusions: Our results suggests that elevations in nocturnal BP precedes DN and increases the risk to develop CVE in hypertensive patients with T2DM. |
publishDate |
2010 |
dc.date.issued.fl_str_mv |
2010-08-13 |
dc.date.accessioned.fl_str_mv |
2016-01-24T14:05:20Z |
dc.date.available.fl_str_mv |
2016-01-24T14:05:20Z |
dc.type.status.fl_str_mv |
info:eu-repo/semantics/publishedVersion |
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info:eu-repo/semantics/article |
format |
article |
status_str |
publishedVersion |
dc.identifier.citation.fl_str_mv |
Cardiovascular Diabetology. London: Biomed Central Ltd, v. 9, 6 p., 2010. |
dc.identifier.uri.fl_str_mv |
http://repositorio.unifesp.br/handle/11600/32821 http://dx.doi.org/10.1186/1475-2840-9-36 |
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1475-2840 |
dc.identifier.file.none.fl_str_mv |
WOS000282267300001.pdf |
dc.identifier.doi.none.fl_str_mv |
10.1186/1475-2840-9-36 |
dc.identifier.wos.none.fl_str_mv |
WOS:000282267300001 |
identifier_str_mv |
Cardiovascular Diabetology. London: Biomed Central Ltd, v. 9, 6 p., 2010. 1475-2840 WOS000282267300001.pdf 10.1186/1475-2840-9-36 WOS:000282267300001 |
url |
http://repositorio.unifesp.br/handle/11600/32821 http://dx.doi.org/10.1186/1475-2840-9-36 |
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eng |
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Cardiovascular Diabetology |
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Biomed Central Ltd |
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Biomed Central Ltd |
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